Request for Testing

Psychoeducational Evaluations: $1,650.00*

Speech-Language Evaluations: $350.00*

Each evaluation includes:

  • Testing
  • Post-assessment conference to discuss findings
  • Recommendations for home and school
  • Problem solving techniques
  • Comprehensive written report

* Prices subject to change

Please complete the information below if interested in scheduling an evaluation.

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Parent/Guardian Name
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A good time to reach you during the day
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Preferred contact phone number or email
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Secondary contact phone number or email
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Client/Student Name
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Date of Birth
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Current grade level or most recently completed (if applicable)
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Current school or last attended
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Are you interested in:

 (1 required)
Psychoeducational Evaluation   Speech-Language Evaluation
Both
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If interested in a Psychological Evaluation please check all that apply to your child:
Limited academic progress   Extended time needed on standardized tests
Lack of academic motivation   Questions related to aptitudes and abilities, including accelerated development
Poor attitude toward teachers and school   Problems with organization and/or study skills
Depression/anxiety   Inattentive, impulsive, hyperactive behaviors
Disruptive behavior   Difficulty making and keeping friends
Social or emotional immaturity   Global developmental delays
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If interested in a Speech-Language Evaluation please check all that apply to your child:
Difficulty pronouncing words correctly   Difficulty understanding/following directions
Limited vocabulary   Trouble producing grammatically complete sentences
Inappropriate volume or tone   Stutters - repeats parts of words or whole words
Difficulty in social issues, such as limited eye contact or conversation skills
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Who referred you to the Assessment Center and Speech Language Clinic at Oak Hill Academy?
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Please describe any additional concerns:
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Additional comments:

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